Is I51.5 a billable ICD-10-CM code?

Yes. I51.5 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does I51.5 sit in the tabular list?

Diseases of the circulatory system (I00-I99), in the block Other forms of heart disease (I30-I5A).

What cannot be coded together with I51.5?

I51.5 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

I51.5

I51.5 — Myocardial degeneration

Billable / specific codeICD-10-CM

I51.5 is a billable, specific ICD-10-CM code for myocardial degeneration. It is valid for submission on a claim.

Excludes1 — never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

myocardial degeneration due to hypertension (I11.-)
myocardial degeneration due to hypertension and chronic kidney disease (I13.-)

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Fatty degeneration of heart or myocardium
Myocardial disease
Senile degeneration of heart or myocardium

Risk adjustment

I51.5 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:

HCC 227 Cardiomyopathy/Myocarditis0.189 RAF

Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.

Medicare coverage

I51.5 is named in 13 Medicare coverage policies — 13 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A52850Billing and Coding: Cardiac Catheterization and Coronary Angiography
A52850Billing and Coding: Cardiac Catheterization and Coronary Angiography
A56476Billing and Coding: Cardiac Radionuclide Imaging
A56476Billing and Coding: Cardiac Radionuclide Imaging

How I51.5 is indexed

Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to I51.5.

Cardiomalacia
Cardiomyoliposis
Myocytolysis
Degeneration, degenerative›myocardial, myocardium(fatty) (hyaline) (senile)
Disease, diseased›myocardium, myocardial
Stricture›myocardium, myocardial
Syndrome›Beau's

Related codes at this level

Codes that share I51. If I51.5 is not quite right, the correct code is usually one of these.

Questions about I51.5

Is I51.5 a billable ICD-10-CM code?: Yes. I51.5 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does I51.5 sit in the tabular list?: Diseases of the circulatory system (I00-I99), in the block Other forms of heart disease (I30-I5A).
What cannot be coded together with I51.5?: I51.5 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.